Active NPI 1790978088 Individual Practitioner Female Practitioner

Rita Sue Mitchell , RN, MSN, FNP

Nurse Practitioner - Family • Lubbock, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Rita Mitchell, RN, MSN, FNP is a certified Nurse Practitioner - Family practicing in Lubbock, TX. With approximately 19 years of clinical experience since completing medical education in 2007, Rita Mitchell delivers high-quality medical care to the local community at 7008 INDIANA AVE STE A.

Rita Mitchell is affiliated with Lfm Associates and accepts Medicare assignment.

Frequently performed procedures and clinical services include residence visit for established patient with moderate level of medical decision making, per day, if using time, at least, residence visit for established patient with high level of medical decision making, per day, if using time, at least, subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7008 Indiana Ave Ste A

Lubbock, TX 794136138

Telephone 8066988088

Associated Practice Facility / Clinic

🏢 Lfm Associates Facility NPI 1255925756

Medicare Profile & Education

Medical School

Other

Graduation Year

2007

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Family in Lubbock, TX

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

19 Yrs +9.3 yrs vs City Avg

City Avg: 9.7 Yrs

State Avg: 8.8 Yrs

Regional Practice Density

438 Specialists

Practicing in Lubbock, TX (21454 Statewide)

Telehealth Adoption Rate

5.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

56.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mitchell (19 Years) 19 Yrs

Lubbock Specialty Average (9.7 Years) 9.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	1,285	163	$243.51	$103.17
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	980	156	$354.13	$150.08
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	732	130	$183.34	$87.00
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	546	112	$267.94	$124.26
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	337	110	$147.58	$62.12
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	192	22	$204.92	$87.09
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	176	22	$292.99	$124.35
99497 Advance care planning, first 30 minutes	174	140	$158.24	$66.55
99497 Advance care planning, first 30 minutes	124	109	$165.31	$60.97
99306 Initial nursing facility visit, typically 45 minutes per day	116	110	$276.72	$147.43
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	106	106	$248.83	$104.95
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	78	32	$136.69	$60.20
36415 Insertion of needle into vein for collection of blood sample	66	40	$31.36	$8.65
99496 Transitional care management services for problem of high complexity	51	42	$518.92	$226.16
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	50	48	$118.84	$50.60
99316 Nursing facility discharge management, more than 30 minutes	43	41	$144.88	$105.90
99345 Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes	37	37	$386.86	$163.48
96139 Administration of psychological or neuropsychological test by technician, each additional 30 minutes	35	35	$66.00	$27.89
99483 Assessment of and care planning for patient with impaired thought processing, typically 50 minutes	35	35	$521.00	$221.28
96132 Evaluation of neuropsychological test, first hour	35	35	$247.00	$105.19
96138 Administration of psychological or neuropsychological test by technician, first 30 minutes	35	35	$64.00	$27.10
99306 Initial nursing facility visit, typically 45 minutes per day	19	17	$347.89	$147.00
81002 Urinalysis, manual test	18	15	$40.00	$3.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	937	177	$187.96	$86.91
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	683	161	$272.49	$124.94
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	598	93	$243.13	$104.11
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	391	55	$201.60	$86.90
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	389	79	$353.94	$151.94
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	371	84	$146.58	$62.52
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	299	80	$148.62	$64.61
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	255	52	$289.62	$124.92
99497 Advance care planning, first 30 minutes	143	123	$158.36	$67.41
99497 Advance care planning, first 30 minutes	139	130	$164.25	$61.65
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	136	52	$137.89	$60.61
99306 Initial nursing facility visit, typically 45 minutes per day	113	104	$291.28	$148.74
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	69	69	$246.00	$105.05
99306 Initial nursing facility visit, typically 45 minutes per day	63	61	$301.71	$148.67
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	60	59	$248.40	$106.15
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	49	17	$141.00	$60.54
99496 Transitional care management services for problem of high complexity	39	33	$507.54	$225.15
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	34	33	$117.47	$49.76
99316 Nursing facility discharge management, more than 30 minutes	34	31	$146.88	$107.04
36415 Insertion of needle into vein for collection of blood sample	29	19	$31.03	$8.40
99345 Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes	21	21	$388.52	$165.16
99316 Nursing facility discharge management, more than 30 minutes	11	11	$244.64	$107.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,182	189	$177.04	$73.85
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	829	167	$260.96	$109.03
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	474	70	$248.59	$104.32
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	442	99	$138.00	$57.70
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	368	79	$175.00	$74.07
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	269	59	$161.50	$67.93
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	267	71	$259.00	$109.38
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	238	80	$134.23	$55.98
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	233	57	$343.71	$144.42
99497 Advance care planning, first 30 minutes	189	178	$166.37	$63.34
99306 Initial nursing facility visit, typically 45 minutes per day	152	148	$279.35	$133.79
99497 Advance care planning, first 30 minutes	91	74	$163.89	$69.34
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	76	76	$254.92	$107.43
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	62	58	$261.00	$109.12
99316 Nursing facility discharge management, more than 30 minutes	53	48	$139.42	$84.41
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	45	28	$133.00	$56.17
36415 Insertion of needle into vein for collection of blood sample	42	22	$29.52	$2.98
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	34	24	$198.00	$82.92
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	29	28	$121.00	$50.68
99496 Transitional care management services for problem of high complexity	26	22	$516.62	$228.50
11042 Removal of skin and tissue, 20.0 sq cm or less	21	15	$256.00	$47.52
99345 Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes	12	12	$422.00	$177.78
99316 Nursing facility discharge management, more than 30 minutes	11	11	$201.00	$84.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	946	133	$177.50	$74.89
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	935	159	$176.18	$74.89
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	656	147	$261.14	$111.10
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	542	119	$262.26	$111.10
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	280	68	$134.20	$56.64
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	264	41	$250.73	$105.43
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	198	44	$346.71	$147.39
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	194	34	$162.61	$68.95
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	183	74	$133.18	$56.64
99497 Advance care planning, first 30 minutes	174	171	$166.34	$64.34
99306 Initial nursing facility visit, typically 45 minutes per day	157	154	$308.93	$136.30
99497 Advance care planning, first 30 minutes	57	52	$166.04	$70.58
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	55	55	$257.00	$107.63
99316 Nursing facility discharge management, more than 30 minutes	45	45	$203.22	$86.36
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	29	29	$119.21	$49.00
99316 Nursing facility discharge management, more than 30 minutes	29	27	$159.93	$86.36
99318 Nursing facility annual assessment, typically 30 minutes	25	25	$185.60	$78.68
99496 Transitional care management services for problem of high complexity	25	24	$522.80	$231.11
99345 Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes	11	11	$427.09	$181.06
99306 Initial nursing facility visit, typically 45 minutes per day	11	11	$322.00	$136.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,607	199	$179.94	$76.05
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	904	169	$179.86	$75.52
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	707	167	$264.05	$112.11
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	592	150	$264.05	$111.97
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	511	107	$136.00	$57.57
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	277	43	$253.99	$107.81
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	231	91	$136.00	$56.96
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	147	30	$166.00	$70.44
99306 Initial nursing facility visit, typically 45 minutes per day	145	145	$313.86	$138.09
99497 Advance care planning, first 30 minutes	132	130	$167.80	$65.77
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	117	39	$353.95	$149.92
99497 Advance care planning, first 30 minutes	70	56	$168.00	$71.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	63	63	$226.05	$95.90
99316 Nursing facility discharge management, more than 30 minutes	56	52	$208.00	$88.04
99316 Nursing facility discharge management, more than 30 minutes	48	44	$168.06	$88.15
99496 Transitional care management services for problem of high complexity	42	40	$474.10	$202.19
99318 Nursing facility annual assessment, typically 30 minutes	40	40	$190.00	$80.41
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	26	26	$122.00	$51.92
99306 Initial nursing facility visit, typically 45 minutes per day	25	25	$330.00	$140.03
99495 Transitional care management services for problem of at least moderate complexity	23	23	$353.09	$152.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,695	282	$180.00	$75.39
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	1,073	258	$266.49	$111.77
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	653	158	$180.00	$75.37
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	622	184	$136.00	$56.70
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	340	130	$268.00	$111.72
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	229	88	$136.00	$56.68
99306 Initial nursing facility visit, typically 45 minutes per day	205	194	$301.66	$137.87
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	195	36	$253.06	$106.67
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	176	43	$352.00	$148.06
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	100	30	$166.00	$69.50
99497 Advance care planning, first 30 minutes	84	79	$166.42	$65.46
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	75	75	$229.00	$94.73
99316 Nursing facility discharge management, more than 30 minutes	65	63	$164.69	$87.25
99497 Advance care planning, first 30 minutes	49	47	$166.00	$70.09
99306 Initial nursing facility visit, typically 45 minutes per day	42	42	$329.00	$137.94
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	40	38	$124.00	$51.14
99496 Transitional care management services for problem of high complexity	35	35	$454.03	$189.19
99316 Nursing facility discharge management, more than 30 minutes	30	30	$209.00	$87.25
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	13	13	$337.00	$140.14
99495 Transitional care management services for problem of at least moderate complexity	11	11	$320.09	$134.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,487	254	$179.55	$74.65
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,159	238	$179.41	$75.60
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	773	206	$265.52	$110.70
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	608	173	$266.53	$112.48
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	568	164	$135.87	$56.42
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	436	134	$135.61	$56.99
99306 Initial nursing facility visit, typically 45 minutes per day	242	222	$303.43	$136.19
99497 Advance care planning, first 30 minutes	148	138	$166.45	$64.48
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	136	41	$351.91	$148.13
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	116	52	$251.89	$106.54
99497 Advance care planning, first 30 minutes	99	88	$166.01	$69.70
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	81	34	$166.00	$69.69
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	76	73	$124.00	$51.93
99316 Nursing facility discharge management, more than 30 minutes	67	61	$207.44	$87.72
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	51	51	$337.00	$140.82
99316 Nursing facility discharge management, more than 30 minutes	45	43	$143.40	$85.51
99496 Transitional care management services for problem of high complexity	42	40	$454.10	$189.89
99306 Initial nursing facility visit, typically 45 minutes per day	38	37	$327.45	$138.11
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	18	14	$88.00	$36.79
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	17	17	$229.00	$95.47
99495 Transitional care management services for problem of at least moderate complexity	12	12	$320.17	$133.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,613	284	$158.02	$74.30
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	1,095	196	$150.56	$74.68
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	734	240	$231.73	$110.76
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	449	153	$121.76	$56.15
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	398	143	$226.08	$110.91
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	314	118	$118.49	$56.32
99306 Initial nursing facility visit, typically 45 minutes per day	118	113	$253.98	$135.70
99349 Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	78	45	$218.59	$105.61
99350 Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes	67	35	$274.00	$146.43
11042 Removal of skin and tissue, 20.0 sq cm or less	66	24	$219.73	$92.62
99316 Nursing facility discharge management, more than 30 minutes	44	42	$160.32	$86.32
99348 Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	34	25	$122.00	$69.29
99318 Nursing facility annual assessment, typically 30 minutes	30	30	$196.93	$78.88
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	25	23	$130.00	$51.33
99306 Initial nursing facility visit, typically 45 minutes per day	14	14	$235.00	$137.18

Medical Specialties & State Licenses

CMS Verified: 2026-06-16

Nurse Practitioner - Family Primary Specialty

NUCC Taxonomy Code: 363LF0000X

State License TX AP116241

Definition to come...

Registered Nurse - Administrator

NUCC Taxonomy Code: 163WA2000X

State License TX 601620

Definition to come...

Hospital & Practice Group Affiliations

Lfm Associates

7008 Indiana Ave, Lubbock, TX 794136138

Phone: 8066988088

Secondary Practice Locations

9812 Slide Rd

Lubbock, TX 794245781

Phone: 8067258400

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

14 Associated Practitioners

Kelli Tyler Hayes , FNP

Nurse Practitioner - Family

NPI 1003084567

Family Nurse Practitioner

James Bush , NURSE PRACTITIONER

Nurse Practitioner - Family

NPI 1063402428

NURSEPRACTITIONER

Brittney Brozo , FNP-C

Nurse Practitioner - Family

NPI 1134084304

Family Nurse Practitioner (Certified)

Dr. David Vermillion , MD

Emergency Medicine

NPI 1194754424

Doctor of Medicine (M.D.)

Tiffany Chavez , FNP-C

Nurse Practitioner - Family

NPI 1225617061

Family Nurse Practitioner (Certified)

Dr. Kimberly Spencer Schup , MD

General Practice

NPI 1487869293

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location June 16, 2026

Registered at 7008 INDIANA AVE STE A, LUBBOCK, TX 794136138 (Tel: 8066988088)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 16, 2026

Nurse Practitioner (License #AP116241 in TX)

✅

NPI Profile Active March 31, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location March 31, 2008

Registered at 4320 19TH ST, LUBBOCK, TX 794072407 (Tel: 8067951774)

📍

Updated Business Mailing Address March 31, 2008

Registered at 10510 HARTFORD AVE, LUBBOCK, TX 794236012 (Tel: 8062390144)

👤

Provider Name / Credentials Updated March 31, 2008

Recorded as RITA MITCHELL, RN,MSN, FNP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 31, 2008

Registered Nurse (License #601620 in TX)

🟢

Initial NPI Registration & Enumeration August 21, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1790978088

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 21, 2007

Last Update: June 16, 2026

Sole Proprietor: No

Update or Correct Profile

Mailing Address

10510 Hartford Ave

Lubbock, TX 794236012

Phone: 8063003209

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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